There is a need for objective sensitive and reproducible methods of assessing skin sclerosis. We performed a cross sectional non-interventional study to evaluate the utility of accoustic radiation force impulse (ARFI) and shear wave elasticity imaging (SWEI) to quantify skin stiffness among healthy volunteers (HV) patients with cutaneous graft-versus-host disease (GVHD) morphea and systemic sclerosis (SSc). The average tissue displacement in skin with clinical sclerosis scores equal to 1 2 and 3 was 1.00 1.66 and 2.45 µm lower than normal appearing skin (p<0.001) respectively. The average shear wave speed (SWS) across skin with a sclerosis score equal to 1 2 and 3 was 0.73 1.25 and 3.10 m/s higher than the SWS values from normal appearing skin (all p<0.001) respectively. Clinically normal appearing skin among patients with morphea and SSc but not GVHD was stiffer compared to HV skin when measured by ARFI. BMI and body site were other independent factors that affected tissue displacement whereas only body site was an independent factor for SWS. ARFI and SWEI may allow for accurate and early detection of skin stiffness among patients with cutaneous fibrosing disorders.
